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amifostine

Generic Name: amifostine (AM i FOS teen)
Brand Name: Ethyol

What is amifostine?

Amifostine a chemoprotectant (KEEM-o-pro-TEK-tant) that can help lessen the side effects of certain cancer chemotherapy medications or radiation treatment.

Amifostine is used to protect the kidneys from harmful effects caused by cisplatin when given to patients with ovarian cancer.

Amifostine is also used to prevent severe dry mouth caused by radiation treatment of the head and neck, which can affect the salivary gland.

Amifostine will not prevent all side effects of chemotherapy medications. However, this medication may help protect your body from some of the serious side effects that chemotherapy can cause.

Amifostine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about amifostine?

You should not use amifostine if you are allergic to it.

Before you receive amifostine, tell your doctor if you have kidney disease, low or high blood pressure, low levels of calcium in your blood, heart disease, a heart rhythm disorder, congestive heart failure, circulation problems, a history of stroke, if you are dehydrated, or if you have any rash or blisters on your hands, feet, lips, or mouth.

Avoid taking blood pressure medication within 24 hours before you receive amifostine. Talk with your doctor if you are concerned about stopping the blood pressure medication for a short time.

Some of the side effects of amifostine may occur up to several weeks after you receive this medication.

Serious side effects include feeling like you might pass out, chest pain, fast or slow heart rate, weak or shallow breathing, seizure, severe skin rash, or urinating less than usual or not at all.

What should I discuss with my healthcare provider before receiving amifostine?

You should not receive amifostine if you are allergic to it.

To make sure you can safely use amifostine, tell your doctor if you have any of these other conditions:

  • kidney disease;

  • low blood pressure;

  • high blood pressure;

  • any rash, redness, blisters, or swelling of your hands, feet, lips, or mouth;

  • low levels of calcium in your blood (hypocalcemia);

  • heart disease, a heart rhythm disorder, congestive heart failure;

  • circulation problems or a history of stroke, including TIA ("mini-stroke");

  • if you are dehydrated; or

  • if you take blood pressure medication.

FDA pregnancy category C. It is not known whether amifostine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether amifostine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using amifostine.

How is amifostine given?

Amifostine is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Amifostine may be given slowly, and the IV infusion can take up to 15 minutes to complete.

You may need to drink extra liquids before you receive amifostine. Follow your doctor's instructions.

You may be given other medications to prevent nausea or vomiting while you are receiving amifostine.

To be sure this medication is not causing harmful effects, your blood pressure will be watched closely while you are receiving amifostine. If you have stopped taking blood pressure medication the day before your amifostine infusion, your caregivers will continue to check your blood pressure for a short time after your infusion.

Your doctor may have you take a calcium supplement while you are receiving amifostine. Take only the amount of calcium that your doctor has prescribed.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.

What should I avoid while taking amifostine?

Avoid taking blood pressure medication within 24 hours before you receive amifostine. Talk with your doctor if you are concerned about stopping the blood pressure medication for a short time.

Avoid getting up too fast from a sitting or lying position after your amifostine infusion, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Amifostine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives, itching; chest tightness, difficult breathing; fever or chills; swelling of your face, lips, tongue, or throat.

Some of the side effects of amifostine may occur up to several weeks after you receive this medication.

Tell your caregiver right away if you have a serious side effect such as:

  • feeling like you might pass out;

  • chest pain, fast or slow heart rate;

  • weak or shallow breathing;

  • seizure (convulsions);

  • urinating less than usual or not at all;

  • severe skin rash on your stomach, back, or trunk;

  • redness, rash, or blisters on the palms of your hands or the soles of your feet; or

  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include:

  • nausea, vomiting;

  • dizziness, drowsiness;

  • flushing (warmth, redness, or tingly feeling);

  • cold feeling;

  • hiccups;

  • sneezing; or

  • mild fever, general ill feeling.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Amifostine dosing information

Usual Adult Dose for Non-Small Cell Lung Cancer:

To reduce the cumulative renal toxicity associated with repeated administration of cisplatin: 910 mg/m2 administered once daily as a 15 minute IV infusion, starting 30 minutes prior to chemotherapy.

The 15 minute infusion is better tolerated than more extended infusions. Further reductions in infusion times for chemotherapy regimens have not been systematically investigated.

Patients should be adequately hydrated prior to amifostine infusion and kept in a supine position during the infusion. Blood pressure should be monitored every 5 minutes during the infusion, and thereafter as clinically indicated.

The infusion of amifostine should be interrupted if the systolic blood pressure decreases significantly from the baseline value as listed in the guideline below:
1) baseline systolic blood pressure is <100 mm Hg and decreases by 20 mm Hg during treatment
2) baseline systolic blood pressure is 100-119 mm Hg and decreases by 25 mm Hg during treatment
3) baseline systolic blood pressure is 120-139 mm Hg and decreases by 30 mm Hg during treatment
4) baseline systolic blood pressure is 140-179 mm Hg and decreases by 40 mm Hg during treatment
5) baseline systolic blood pressure is >=180 mm Hg and decreases by 50 mm Hg during treatment

If the blood pressure returns to normal within 5 minutes and the patient is asymptomatic, the infusion may be restarted so that the full dose of amifostine may be administered. If the full dose of amifostine cannot be administered, the dose of amifostine for subsequent chemotherapy cycles should be 740 mg/m2.

It is recommended that antiemetic medication, including dexamethasone 20 mg intravenously and a serotonin 5-HT3 receptor antagonist, be administered prior to and in conjunction with amifostine. Additional antiemetics may be required based on the chemotherapy drugs administered.

Usual Adult Dose for Ovarian Cancer:

To reduce the cumulative renal toxicity associated with repeated administration of cisplatin: 910 mg/m2 administered once daily as a 15 minute IV infusion, starting 30 minutes prior to chemotherapy.

The 15 minute infusion is better tolerated than more extended infusions. Further reductions in infusion times for chemotherapy regimens have not been systematically investigated.

Patients should be adequately hydrated prior to amifostine infusion and kept in a supine position during the infusion. Blood pressure should be monitored every 5 minutes during the infusion, and thereafter as clinically indicated.

The infusion of amifostine should be interrupted if the systolic blood pressure decreases significantly from the baseline value as listed in the guideline below:
1) baseline systolic blood pressure is <100 mm Hg and decreases by 20 mm Hg during treatment
2) baseline systolic blood pressure is 100-119 mm Hg and decreases by 25 mm Hg during treatment
3) baseline systolic blood pressure is 120-139 mm Hg and decreases by 30 mm Hg during treatment
4) baseline systolic blood pressure is 140-179 mm Hg and decreases by 40 mm Hg during treatment
5) baseline systolic blood pressure is >=180 mm Hg and decreases by 50 mm Hg during treatment

If the blood pressure returns to normal within 5 minutes and the patient is asymptomatic, the infusion may be restarted so that the full dose of amifostine may be administered. If the full dose of amifostine cannot be administered, the dose of amifostine for subsequent chemotherapy cycles should be 740 mg/m2.

It is recommended that antiemetic medication, including dexamethasone 20 mg intravenously and a serotonin 5-HT3 receptor antagonist, be administered prior to and in conjunction with amifostine. Additional antiemetics may be required based on the chemotherapy drugs administered.

Usual Adult Dose for Malignant Disease:

For reduction of moderate to severe xerostomia in patients undergoing postoperative radiation treatment for head and neck cancer, where the radiation port includes a substantial portion of the parotid glands:
The recommended dose of amifostine is 200 mg/m2 administered once daily as a 3 minute intravenous infusion, starting 15 to 30 minutes prior to standard fraction radiation therapy (1.8-2.0 Gy).

Patients should be adequately hydrated prior to amifostine infusion. Blood pressure should be monitored at least before and immediately after the infusion, and thereafter as clinically indicated.

It is recommended that antiemetic medication be administered prior to and in conjunction with amifostine. Oral 5-HT3 receptor antagonists, alone or in combination with other antiemetics, have been used effectively in the radiotherapy setting.

What other drugs will affect amifostine?

Tell your doctor about all other medicines you use, especially medicines to treat high blood pressure.

There may be other drugs that can interact with amifostine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about amifostine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.01.

Last reviewed: April 25, 2012
Date modified: November 30, 2016

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